脉搏指数连续心输出量监测技术对颅脑损伤亚低温治疗循环系统并发症控制的有效性

doi:10.3969/j.issn.1004-583X.2016.01.017

临床荟萃 ›› 2016, Vol. 31 ›› Issue (1): 68-70.doi: 10.3969/j.issn.1004-583X.2016.01.017

脉搏指数连续心输出量监测技术对颅脑损伤亚低温治疗循环系统并发症控制的有效性

孙志辉, 刘秦勤, 王敏, 齐英杰, 李晖

酒泉市人民医院重症医学科,甘肃酒泉 735000

收稿日期:2015-10-21 出版日期:2016-01-05 发布日期:2016-04-19
通讯作者: 孙志辉,Email:sun8012152005@sohu.com

Effectiveness research of PICCO on the control of circulation system complications during mild hypothermia in patients with craniocerebral injury

Sun Zhihui, Liu Qinqin, Wan Min, Qi Yingjie, Li Hui

Department of Intensive Care Unit, Jiuquan People’s Hospital, Jiuquan 735000, China

Received:2015-10-21 Online:2016-01-05 Published:2016-04-19
Contact: Sun Zhihui, Email: sun8012152005@sohu.com

摘要/Abstract

摘要： 目的探讨脉搏指数连续心输出量监测(PICCO)技术对重度颅脑损伤亚低温治疗循环系统并发症控制有效性。方法回顾分析2012年3月至2015年9月入住重症医学科(ICU)的重型颅脑损伤行亚低温治疗患者70例,分为常规组和PICCO组,PICCO组通过PICCO监测仪实时监测患者血流动力学,依靠数据资料维持稳定血流动力学,常规组因家属拒绝行PICCO监测,仅用心率(P)、有创动脉压(MAP)监测患者血流动力学,使血流动力学稳定。结果亚低温治疗循环系统并发症主要发生在降温期和低温期, PICCO组低血压发生率低于常规组(P<0.05),PICCO组液体入量比常规组少(P<0.01);治疗21天后,PICCO组格拉斯哥昏迷指数(GCS)评分高于常规组(P<0.01);PICCO组ICU住院时间短于常规组(P<0.05)。结论对于严重颅脑损伤亚低温治疗中,PICCO监测技术可实时监测血流动力学指数,合理的指导液体管理及冬眠药物的剂量,可以有效控制亚低温治疗中心律失常、低血压及神经源性肺水肿等并发症,降低亚低温治疗循环系统并发症发生率,提高患者生存率,降低致残率,减轻社会负担。

关键词: 颅脑损伤, 低温, 并发症, 重症监护

Abstract: Objective To explore the effectiveness of pulse-indicated continuous cardiac output (PICCO) technology on the control of circulation system complications during mild hypothermia in patients with craniocerebral injury.Methods A total of 70 patients with severe craniocerebral injury receiving mild hypothermia therapy in intensive care unit (ICU) from September, 2012 to March, 2015 were retrospectively analyzed. All patients were divided into control group with heart rate (P) and invasive arterial pressure (MAP) monitor and PICCO group with PICCO monitor.Results The circulatory complications during mild hypothermia therapy mainly occurred in cooling stage and low temperature stage, the incidence of low blood pressure of PICCO group was significantly lower than that of control group (P<0.05); and the liquid intake of PICCO group was significantly lower than that of control group (P<0.01); After 21 days of treatment, the Glasgow Coma Scale (GCS) scores of PICCO group was significantly higher than that of control group (P<0.01) and the length of hospital stay was significantly shorter than that of control group (P<0.05). Conclusion As for patients with severe craniocerebral injury receiving mild hypothermia therapy, PICCO monitoring technology can monitor the hemodynamic indexes in real-time manner, reasonably regulate fluid management and the dosage of hibernation drugs, effectively exert control on complications such as arrhythmia, hypotension and neurogenic pulmonary edema caused by mild hypothermia therapy to reduce the incidence rate of complications, so as to improve the survival rate of patients and reduce morbidity as well as lowering the burden on society.

Key words: craniocerebral injury, hypothermia, complications, intensive care

中图分类号:

R651

孙志辉, 刘秦勤, 王敏, 齐英杰, 李晖. 脉搏指数连续心输出量监测技术对颅脑损伤亚低温治疗循环系统并发症控制的有效性[J]. 临床荟萃, 2016, 31(1): 68-70.

Sun Zhihui, Liu Qinqin, Wan Min, Qi Yingjie, Li Hui. Effectiveness research of PICCO on the control of circulation system complications during mild hypothermia in patients with craniocerebral injury[J]. Clinical Focus, 2016, 31(1): 68-70.

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https://huicui.hebmu.edu.cn/CN/Y2016/V31/I1/68

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脉搏指数连续心输出量监测技术对颅脑损伤亚低温治疗循环系统并发症控制的有效性

Effectiveness research of PICCO on the control of circulation system complications during mild hypothermia in patients with craniocerebral injury

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